Rhinitis epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]
Overview
Rhinitis is a very frequent and highly prevalent global disease, and it is one of the most common conditions presenting for medical care in developed countries.[1]
Epidemiology and Demographics
Prevalence
Rhinitis is a highly prevalent disease with significant financial impact on the society.[2] Chronic rhinitis is one of the most common problems seen by physicians.[1] Allergic rhinitis is estimated to affect one in every six Americans, and it is the fifth most chronic disease in the U.S.[3] Allergic rhinitis is the most common chronic disease in the pediatric age group in the U.S,[3] and it was the most common diagnosis reported in the 2000 Otolaryngology Workforce study.[4] The estimated prevalence of allergic rhinitis ranges from 9-42%.[5] Annually, between 30-60 million people in the U.S suffer from allergic rhinitis, 10-30% of these individuals are adults, and up to 40% are children.[1] The prevalence of allergic rhinitis has been found to be increasing in countries worldwide, and factors such as increased airborne pollution, a rise in the population of dust mite in inadequately ventilated offices/homes with central heating/air conditioning, and sedentary lifestyles, have been suggested to contribute to the rise in its prevalence.[6][7][8] The prevalence of allergic rhinitis has significantly increased during the past 50 years, with over 50% of adolecents in some countries reporting symptoms of allergic rhinitis.[7] The prevalence of allergic rhinitis was noticed to have doubled in several countries over the last two decades in studies done in children between the ages 6-14years around the globe.[8] Nonallergic rhinitis is also very common, and it has been estimated to affect about 19 million people in the U.S.[5] There is sometimes an overlap between allergic and nonallergic rhinitis, referred to as "mixed rhinitis", and this has been estimated to affect about 26 million individuals in the United States.[5] The overall prevalence of occupational rhinitis is unknown but it has been estimated to affect between 23-50% of bakers in Norway.[9]
Age
Rhinitis affects all age groups. Allergic rhinitis is the most common chronic disease of childhood,[10] with symptoms developing in one of five children by 2-3 years of age.[11] Up to 40% of of children have symptoms of allergic rhinitis by the age of six.[11] The onset of nonallergic (non-infectious) rhinitis is often after the age of 20 years.[5] Primary atrophic rhinitis is more commonly seen in young to middle-aged adults.[12]
| Pattern of Allergic and Infectious rhinitis in children[10] | ||
|---|---|---|
| Age | Allergic rhinitis | Infectious rhinitis |
| Neonates and Infants | +/- | ++ |
| Pre-school age | ++ | ++ |
| School age | +++ | ++ |
| Pre-adolescent | +++ | + |
Sex
- Allergic rhinitis appears to be more common in boys during childhood, but males and females are equally affected during adulthood.[11]
- Nonallergic (non-infectious) rhinitis is predominantly seen in females.[5]
- Primary atrophic rhinitis is more common in females, with a female:male ratio of 5.6:1.[13]
Geographical Distribution
Rhinitis is a global disease with wide inter-regional and intra-regional variations in its prevalence.[8] A study on the prevalence and diversity of allergic rhinitis in regions of the world (several countries in Africa, the Asia-Pacific region, Australia, Eastern Europe, Latin America, Middle East and Turkey), showed wide variations in the prevalence of allergic rhinitis, ranging from 2.9% to 54.1%.[8] Primary atrophic rhinitis is more prevalent in developing countries with warm climates.[12] The prevalence of primary atrophic rhinitis varies in different parts of the world, affecting about 0.3-1% of the population in countries where it is highly prevalent.[13] It has been found to be a common condition in tropical countries like India.[13]
Cost
Chronic rhinitis constitute a huge financial burden to the society.[2] Allergic rhinitis generates between $1.6-$4.9 billion in direct healthcare expenditure in the United States, and an indirect cost of about $0.1-$9.7 billion due to lost productivity annually.[4]
References
- ↑ 1.0 1.1 1.2 Romeo, Jonathan; Dykewicz, Mark (2014). "Chapter 9:Differential Diagnosis of Rhinitis and Rhinosinusitis". Diseases of the Sinuses. Springer New York. pp. 133–152. ISBN 978-1-4939-0265-1.
- ↑ 2.0 2.1 Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA; et al. (2008). "The diagnosis and management of rhinitis: an updated practice parameter". J Allergy Clin Immunol. 122 (2 Suppl): S1–84. doi:10.1016/j.jaci.2008.06.003. PMID 18662584.
- ↑ 3.0 3.1 Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR; et al. (2015). "Clinical practice guideline: allergic rhinitis executive summary". Otolaryngol Head Neck Surg. 152 (2): 197–206. doi:10.1177/0194599814562166. PMID 25645524.
- ↑ 4.0 4.1 Mims JW (2014). "Epidemiology of allergic rhinitis". Int Forum Allergy Rhinol. 4 Suppl 2: S18–20. doi:10.1002/alr.21385. PMID 25182349.
- ↑ 5.0 5.1 5.2 5.3 5.4 Settipane RA, Charnock DR (2007). "Epidemiology of rhinitis: allergic and nonallergic". Clin Allergy Immunol. 19: 23–34. PMID 17153005.
- ↑ Schoenwetter WF, Dupclay L, Appajosyula S, Botteman MF, Pashos CL (2004). "Economic impact and quality-of-life burden of allergic rhinitis". Curr Med Res Opin. 20 (3): 305–17. doi:10.1185/030079903125003053. PMID 15025839.
- ↑ 7.0 7.1 Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A; et al. (2008). "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen)". Allergy. 63 Suppl 86: 8–160. doi:10.1111/j.1398-9995.2007.01620.x. PMID 18331513.
- ↑ 8.0 8.1 8.2 8.3 Katelaris CH, Lee BW, Potter PC, Maspero JF, Cingi C, Lopatin A; et al. (2012). "Prevalence and diversity of allergic rhinitis in regions of the world beyond Europe and North America". Clin Exp Allergy. 42 (2): 186–207. doi:10.1111/j.1365-2222.2011.03891.x. PMID 22092947.
- ↑ Stevens WW, Grammer LC (2015). "Occupational rhinitis: an update". Curr Allergy Asthma Rep. 15 (1): 487. doi:10.1007/s11882-014-0487-8. PMID 25430949.
- ↑ 10.0 10.1 Rotiroti, Giuseppina; Scadding, Glenis (July 2016). "Allergic Rhinitis-an overview of a common disease". Paediatrics and Child Health. Volume 26 (Issue 7): 298–303. Retrieved January 20, 2017.
- ↑ 11.0 11.1 11.2 Skoner DP (2001). "Allergic rhinitis: definition, epidemiology, pathophysiology, detection, and diagnosis". J Allergy Clin Immunol. 108 (1 Suppl): S2–8. PMID 11449200.
- ↑ 12.0 12.1 Dykewicz MS, Hamilos DL (2010). "Rhinitis and sinusitis". J Allergy Clin Immunol. 125 (2 Suppl 2): S103–15. doi:10.1016/j.jaci.2009.12.989. PMID 20176255.
- ↑ 13.0 13.1 13.2 Bist SS, Bisht M, Purohit JP (2012). "Primary atrophic rhinitis: a clinical profile, microbiological and radiological study". ISRN Otolaryngol. 2012: 404075. doi:10.5402/2012/404075. PMC 3671697. PMID 23762613.